Fighting diabetes with drugs

By Andrew A. Skolnick

March 19, 2000
Edited by Virginia Baldwin Gilbert

More than 13 million people in the United States suffer from adult-onset diabetes, known as type 2 diabetes.

The body needs the hormone insulin to metabolize sugar. However, people with type 2 diabetes do not have enough or have become resistant to insulin.

As a result, blood sugar levels often climb high enough to damage their eyes, kidneys, heart and other organs.

There now are five types of oral drugs approved by the Food and Drug Administration for treating type 2 diabetes. They may be used alone or in addition to insulin injections to control the patient's blood sugar levels:

Hypoglycemic agents

These drugs, also called sulfonylureas, include names such as glipizide, glimepiride and glyburide. They lower blood sugar by stimulating the pancreas to secrete more insulin.


Repaglinide (Prandin) is a newer class of drug that also stimulates the pancreas to secrete more insulin. It is absorbed and cleared from the blood more quickly than sulfonylureas.

Starch blockers

These drugs, also called alpha-glucosidase inhibitors, include acarbose (Precose) and miglitol (Glyset). They reduce the digestion of starches to prevent harmfully high peaks in blood sugar levels.


Metformin (Glucophage) increases the liver's sensitivity to insulin, causing it to reduce the release of blood sugar into the blood.

Insulin sensitizers

This newest class of diabetes drugs, also called glitazones or thiazolidinediones, includes troglitazone (Rezulin), rosiglitazone (Avandia) and pioglitazone (Actos). They work primarily by making the patient's body more sensitive to insulin.